<div class="grid_container">
    <div class="grid_12">
        <?php
        echo $this->Form->create('Consultasexternas', array('id' => "form103", 'class' => "form_container left_label valid_tip"));
//        echo $this->Ajax->form(array('type' => 'post',
//            'options' => array(
//                'model' => 'Pacientes',
//                'update' => 'cargadatos',
//                'id' => 'form103',
//                'class' => 'form_container left_label valid_tip',
//                'url' => array(
//                    'controller' => 'Pacientes',
//                    'action' => 'ajaxencuentrapacienteantecedentes'
//                ),
//            )
//        ));
        ?>
        <div class="widget_wrap">
            <div class="widget_top">
                <span class="h_icon list"></span>
                <h6>BUSCAR PACIENTE</h6>
            </div>
            <div class="widget_content">
                <ul>
                    <li>
                        <div class="form_grid_12">
                            <label class="field_title">Fechas</label>
                            <div class="form_input">
                                <div class=" form_grid_2 alpha">
                                    <input name="fechadesde" type="text" class="datepicker" value="<?php echo date('d-m-Y')?>" data-date-format="dd-mm-yyyy"/>
                                    <span class=" label_intro">Desde</span>
                                </div>
                                <div class=" form_grid_2">
                                    <input name="fechahasta" type="text" class="datepicker" value="<?php echo date('d-m-Y')?>" data-date-format="dd-mm-yyyy"/>
                                    <span class=" label_intro">Hasta</span>
                                </div>
                                <span class="clear"></span>
                            </div>
                        </div>
                    </li>
                    <li>
                        <div class="form_grid_12">

                            <label class="field_title">Busqueda por Codigo: </label>
                            <div class="form_input">                                 

                                <div class="form_grid_3">
                                    <?php //echo $this->Form->text('carnet', array())?>
                                    <input name="data[codigo]" type="text" class="validate number" tabindex="1"/>
                                    <span class=" label_intro">CODIGO</span>
                                </div>

                                <span class="clear"></span>
                            </div>
                        </div>
                    </li>  

                    <li>
                        <div class="form_grid_12">
                            <label class="field_title">Buscar por nombre</label>
                            <div class="form_input">
                                <div class="form_grid_4 alpha">
                                    <?php echo $this->Form->text(null, array('name' => 'data[nombre]', 'tabindex' => 1)) ?>
                                    <span class=" label_intro">Nombre</span>
                                </div>
                                <div class="form_grid_4">
                                    <?php echo $this->Form->text(null, array('name' => 'data[paterno]', 'tabindex' => 1)) ?>
                                    <span class=" label_intro">Apellido paterno</span>
                                </div>
                                <div class="form_grid_4">
                                    <?php echo $this->Form->text(null, array('name' => 'data[materno]', 'tabindex' => 1)) ?>
                                    <span class=" label_intro">Apellido materno</span>
                                </div>
                                <span class="clear"></span>
                            </div>
                        </div>
                    </li>

                    <li>
                        <div class="form_grid_12">
                            <label class="field_title">FECHA DE NACIMIENTO Y CARNET</label>
                            <div class="form_input">
                                <div class="form_grid_2 alpha">
                                    <input name="data[fecha]" type="text" id="date" tabindex="1"/>
                                    <span class=" label_intro">FECHA DE NACIMIENTO (dia/mes/a&ntilde;o)</span>
                                </div>                                    
                                <div class="form_grid_3">
                                    <?php //echo $this->Form->text('carnet', array())?>
                                    <input name="data[ci]" type="text" class="validate number" tabindex="1"/>
                                    <span class=" label_intro">CARNET DE ID</span>
                                </div>

                                <span class="clear"></span>
                            </div>
                        </div>
                    </li>                                                            
                    <li>
                        <div class="form_grid_12">
                            <div class="form_input">

                                <button type="submit" class="btn_small btn_blue"><span>Buscar paciente</span></button>
                                <button type="reset" class="btn_small btn_orange"><span>Limpiar datos</span></button>
                            </div>
                        </div>
                    </li>
                </ul>
                </form>
                <span class="clear"></span>
            </div>
        </div>
    </div>

    <div class="grid_12">
        <div id="cargadatos">
            
        </div>    
    </div>

</div>